Pantoprazole


Thông tin thuốc gốc
Chỉ định và Liều dùng
Intravenous
Zollinger-Ellison syndrome
Adult: 80 mg once or twice daily as slow injection or short-term infusion over 2-15 minutes. Switch to oral therapy as soon as possible.

Intravenous
Gastro-oesophageal reflux disease, Peptic ulcer
Adult: 40 mg daily as slow injection or short-term infusion over 2-15 minutes. Switch to oral therapy as soon as possible.

Oral
Peptic ulcer
Adult: 40 mg once daily (increased up to 80 mg if necessary) for 2-4 weeks for duodenal ulcer or 4-8 weeks for benign gastric ulcer.

Oral
Gastro-oesophageal reflux disease
Adult: 20-40 mg once daily for 4 weeks (increased to 8 weeks if necessary). Maintenance: 20-40 mg daily. Alternatively, 20 mg daily on recurring symptoms.
Child: ≥5 years 15–40 kg: 20 mg once daily for up to 8 weeks; >40 kg: 40 mg once daily for up to 8 weeks.

Oral
Prophylaxis of NSAID-induced ulcers
Adult: 20 mg once daily.

Oral
Zollinger-Ellison syndrome
Adult: 40 mg bid (adjusted up to 240 mg/day if needed). Daily doses >80 mg should be given in 2 divided doses.
Special Patient Group
Pharmacogenomics:

CYP2C19 is one of the major enzymes in the metabolism of pantoprazole and it is known to exhibit genetic polymorphism due to its deficiency in some subpopulations.

CYP2C19 phenotypes are classified as ultrarapid metabolisers (carriers of 2 function alleles e.g. *17/*17), extensive metabolisers (e.g. CYP2C19 *1/*1), intermediate metabolisers (carriers of 1 non-function allele e.g. *1/*2, *1/*3, *17/*2, *17/*3), and poor metabolisers (carriers of 2 non-function alleles e.g. *2/*2, *2/*3, *3/*3).

Certain subpopulations lack CYP2C19 activity, these subpopulations are referred to as poor metabolisers. Approximately 3% of Caucasians and African-Americans, and 17-23% of Asians are poor metabolisers. Although these subpopulations have elimination half-life values of 3.5 to 10 hours in adults, they still have minimal accumulation with once-daily dosing. No dosage adjustment is needed in adult patients who are CYP2C19 poor metabolisers. Paediatric patients who are poor metaboliser exhibited greater than a 6-fold increase in AUC compared to extensive and intermediate metabolisers. Poor metabolisers exhibited approximately 10-fold lower apparent oral clearance compared to extensive metabolisers. Dose reduction should be considered in paediatric poor metaboliser patients.
Hepatic Impairment
Max: 20 mg daily.
Cách dùng
Normal Release: May be taken with or without food.
Controlled-Release: Should be taken on an empty stomach. Take 1 hr before meals. Swallow whole, do not chew/crush.
Hướng dẫn pha thuốc
Reconstitute 40 mg vial with 10 mL 0.9% NaCl inj to make a final concentration of approx 4 mg/mL. IV Infusion: Further dilute with 100 mL of D5W, normal saline, or Lactated Ringer’s inj to achieve a concentration of approx. 0.4 mg/mL. For an 80 mg dose: Reconstitute two 40 mg vials and dilute 10mL of the reconstituted solution in 100 mL of IV infusion solutions.
Chống chỉ định
Concomitant use with rilpivirine and atazanavir.
Thận trọng
Patient with gastric malignancy, risk factors for reduced vitamin B12 absorption or at risk for osteoporosis. Hepatic impairment. Pregnancy and lactation. CYP2C19 poor metabolisers.
Phản ứng phụ
Significant: Hypomagnesaemia, cutaneous lupus erythematosus, SLE, osteoporosis-related fractures, fundic gland polyp, carcinoma, Clostridium difficile-associated diarrhoea, interstitial nephritis, Vitamin B12 deficiency (long-term therapy), gastrointestinal infection (e.g. salmonella, Campylobacter).
Gastrointestinal disorders: Nausea, vomiting, diarrhoea, constipation, flatulence, abdominal pain, dyspepsia, dry mouth.
General disorders and administration site conditions: Asthenia, fatigue, malaise.
Hepatobiliary disorders: Increased liver enzymes.
Immune system disorders: Urticaria.
Metabolism and nutrition disorders: Peripheral oedema.
Musculoskeletal and connective tissue disorders: Arthralgia, myalgia.
Nervous system disorders: Headache, dizziness, vertigo.
Psychiatric disorders: Insomnia.
Reproductive system and breast disorders: Gynaecomastia.
Skin and subcutaneous tissue disorders: Rash, pruritus.
Thông tin tư vấn bệnh nhân
This drug may cause dizziness or visual disturbances, if affected, do not drive or operate machinery.
MonitoringParameters
Monitor bone loss, fractures, Clostridium difficile-associated diarrhoea (CDAD), serum Mg (at baseline and periodically), serum gastrin level concentrations.
Tương tác
May decrease plasma concentrations of rilpivirine and atazanavir. Increased risk of hypomagnesaemia with diuretics. Increased risk of digoxin-induced cardiotoxic effects. May increase INR and prothrombin time of warfarin. May increase plasma concentration of methotrexate. May decrease absorption of itraconazole, ketoconazole, posaconazole, erlotinib. May diminish the therapeutic effect of clopidogrel.
Food Interaction
St John’s wort may decrease serum levels of pantoprazole.
Lab Interference
May increase serum chromogranin A (CgA) levels causing false-positive result in diagnostic tests for neuroendocrine tumours and urine screening tests for tetrahydrocannabinol.
Tác dụng
Description: Pantoprazole is a substituted benzimidazole gastric antisecretory agent and is also known as proton pump inhibitor (PPI). It blocks the final step in gastric acid secretion by specific inhibition of H+/K+ adenosine triphosphatase (ATPase) enzyme system present on the secretory surface of the gastric parietal cell. Both basal and stimulated acid are inhibited.
Onset: 2.5 hours (oral); 15-30 minutes (IV).
Duration: 24 hours.
Pharmacokinetics:
Absorption: Rapidly absorbed. Time to peak plasma concentration: Approx 2-2.5 hours (oral). Bioavailability: Approx 77%.
Distribution: Enters breast milk. Volume of distribution: 11-23.6 L. Plasma protein binding: Approx 98% (mainly to albumin).
Metabolism: Extensive hepatic metabolism, mainly by CYP2C19 isoenzyme to desmethylpantoprazole and slightly by CYP3A4, CYP2D6 and CYP2C9 isoenzymes.
Excretion: Mainly via urine (approx 80%); faeces. Elimination half-life: Approx 1 hour.
Đặc tính

Chemical Structure Image
Pantoprazole

Source: National Center for Biotechnology Information. PubChem Database. Pantoprazole, CID=4679, https://pubchem.ncbi.nlm.nih.gov/compound/Pantoprazole (accessed on Jan. 22, 2020)

Bảo quản
Store between 20-25°C.
Phân loại ATC
A02BC02 - pantoprazole ; Belongs to the class of proton pump inhibitors. Used in the treatment of peptic ulcer and gastro-oesophageal reflux disease (GERD).
References
Annotation of DPWG Guideline for Pantoprazole and CYP2C19. Pharmacogenomics Knowledgebase (PharmGKB). https://www.pharmgkb.org/. Accessed 12/12/2019.

Annotation of FDA Label for Pantoprazole and CYP2C19. Pharmacogenomics Knowledgebase (PharmGKB). https://www.pharmgkb.org/. Accessed 12/12/2019.

Annotation of Swissmedic Label for Pantoprazole and CYP2C19. Pharmacogenomics Knowledgebase (PharmGKB). https://www.pharmgkb.org/. Accessed 12/12/2019.

Anon. CYP2C19-Pantoprazole (Pharmacogenomics). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 12/12/2019.

Anon. Pantoprazole. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 01/03/2019.

Anon. Pantoprazole. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 01/03/2019.

Buckingham R (ed). Pantoprazole. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/03/2019.

Joint Formulary Committee. Pantoprazole. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/03/2019.

Pantoprazole Delayed Release Tablet (Teva Pharmaceuticals USA, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 12/12/2019.

Pantoprazole Sodium Injection, Powder, Lyophilized, for Solution (West-Ward Pharmaceuticals Corp). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 01/03/2019.

Pantoprazole Sodium Tablet, Delayed Release (Teva Pharmaceuticals USA, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 01/03/2019.

Thông báo miễn trừ trách nhiệm: Thông tin này được MIMS biên soạn một cách độc lập dựa trên thông tin của Pantoprazole từ nhiều nguồn tài liệu tham khảo và được cung cấp chỉ cho mục đích tham khảo. Việc sử dụng điều trị và thông tin kê toa có thể khác nhau giữa các quốc gia. Vui lòng tham khảo thông tin sản phẩm trong MIMS để biết thông tin kê toa cụ thể đã qua phê duyệt ở quốc gia đó. Mặc dù đã rất nỗ lực để đảm bảo nội dung được chính xác nhưng MIMS sẽ không chịu trách nhiệm hoặc nghĩa vụ pháp lý cho bất kỳ yêu cầu bồi thường hay thiệt hại nào phát sinh do việc sử dụng hoặc sử dụng sai các thông tin ở đây, về nội dung thông tin hoặc về sự thiếu sót thông tin, hoặc về thông tin khác. © 2021 MIMS. Bản quyền thuộc về MIMS. Phát triển bởi MIMS.com
XEM THÊM
LESS
  • Amfapraz 40
  • Antaloc
  • Aptizole
  • Bio-panto
  • Canozole
  • Clessol
  • Comenazol
  • Cytozol
  • Czoltin
  • Chempen
  • Dogastrol
  • Dypes
  • Fabizol
  • Geopanto
  • Gerdamegh
  • Gescam
  • Hansazol
  • Hasanloc
  • Mefogin
  • Mepantop
  • Nepicox
  • Nolpaza
  • Ontopan
  • Ozanilin
  • Panazo
  • Panido 40
  • Panloz
  • Panneo-40
  • Panral
  • Panrbe
  • Panrixim
  • Pansalve
  • Pantagi
  • Pantalek
  • Pantasun
  • Pantaz
  • Panticlar
  • Pantin
  • Pantium-40
  • Pantobone
  • Pantocar
  • Pantocid
  • Pantokem-40
  • Pantoliv
  • Pantomed
  • Pantonix
  • Pantonova IV
  • Pantoprazol DOMESCO
  • Pantoprazole Madras
  • Pantoprazole Winthrop
  • Pantosec
  • Pantosyn
  • Pantotab
  • Pantowin-M
  • Pantrafar
  • Pantric
  • Panzo-40
  • Patotab
  • Pencer 40
  • Pentaloc 40
  • Pentodus
  • Penzilo
  • Peptazol
  • Pipanzin
  • pms-Pantoprazole
  • PNZ-40 tablets
  • Prasocid-40
  • Protomac
  • Proton-P
  • Protopan
  • Rypanta
  • Sagacid
  • Sahelon
  • Santapanto
  • Sevenkit
  • Sozol
  • SP Extream
  • Teratop
  • TV-Pantoprazol
  • Ulticer
  • Ulzopan
  • Unipan
  • Zovanta-40
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in